Invitation to Bid - Power-Load-Power-Lift Stretcher Systems.pdf

Holbrook Fire Department 300 South Franklin Street

Holbrook, MA 02343

Business line: 781-767-2234 Fax line: 781-767-1738

Town of Holbrook - Invitation For Bids (IFB)

• Project Type: Procurement of Goods and Associated Services Related to Said Goods

• Acquisition Type: Outright Purchase and Installation

• Project Description: Procurement of Power-Lift/Power-Load Stretcher Systems, Installation of same into Fire Department Ambulances, and related Accessories/Services.

General Information

The Holbrook Fire Chief acting as an agent of the Holbrook Board of Selectmen will receive sealed bids for the purchase and installation of:

A. Power Load Stretcher Systems with extended seven (7) year warranties – Quantity: Two (2)

B. Power Lift Stretchers with extended seven (7) year warranties – Quantity: Two (2)

C. Related services and training on use and maintenance of above equipment.

Sealed bids and all associated forms shall be delivered to the:

Holbrook Fire Department

Attention: Fire Chief Luke McFadden

300 South Franklin Street

Holbrook, MA 02343

The bid package shall be submitted in duplicate and marked on the outer portion of the envelope as “Power-

Lift/Power-Load Stretcher System Purchase and Installation”. Bids will be accepted at the Holbrook Fire

Department from 9:00 a.m. on Monday, February 4, 2019 until 12:00 p.m. on Friday, February 22, 2019, and will be opened publicly in the Holbrook Public Safety Building, Lower Level Training Room (located at 300

South Franklin Street, Holbrook, Massachusetts, 02343) immediately following (between approximately noon and 12:15 p.m.) on Friday, February 22, 2019. Awarding of the bid will be within 30 calendar days from the opening date. The Fire Chief/Holbrook Board of Selectmen reserve the right to reject any or all bids and to waive formalities not required by law or take any action it deems to be in the public interest.

Necessary specifications are available at Holbrook Fire Department Headquarters, located in the Holbrook

Public Safety Building, 300 South Franklin Street, Holbrook, MA, 02343.

Bidding procedures shall be in strict compliance with Massachusetts General Law, Chapter 30B and all other applicable laws governing public bidding.

Holbrook Fire Department Power-Lift/Power-Load Stretcher System

Invitation for Bids Notice

All bids must be properly executed in compliance with Massachusetts General Laws, Chapter 30B, Chapter 7, Section 22, Chapter 30, Sections 51 and 52, 801 Commonwealth of Massachusetts Regulations 21.00, and all other applicable laws governing public bidding. All submitted bids will include a certification that the bid was made in good faith and without collusion or fraud. The Board of Selectmen/Fire Chief (awarding authority) shall have a maximum of thirty (30) calendar days from the bid opening to make an award. The time for award may be extended for up to 45 additional days by mutual agreement between the Town and the apparent lowest responsive and responsible bidder (or, for a contract requiring payment to the Town, the apparent highest responsive and responsible bidder.) Notwithstanding the foregoing, the Town reserves the right to cancel this contract on thirty day notice for non-performance or substandard performance.

The Holbrook Board of Selectmen/Fire Chief reserve the right to reject any or all bids and to waive formalities not required by law or take any action it deems to be in the public interest.

Bids will be received at the Holbrook Fire Department from 8:00 a.m. beginning on Monday, February 4, 2019 until 12:00 p.m. on Friday, February 22, 2019, and will be opened publicly in the Holbrook Public Safety

Building, Lower Level Training Room (located at 300 South Franklin Street, Holbrook, Massachusetts, 02343) immediately following (between approximately noon 12:15 p.m.) on Friday, February 22, 2019.

Changes, Questions, and Modification Information

If any changes are made to this Invitation for Bids, an addendum will be issued. Addenda will be emailed to all solicited vendors and/or bidders having submitted bids/quotes.

Questions concerning this Invitation for Bids must be submitted in writing via email or in writing delivered in hand to: Chief Luke McFadden at: chiefmcfadden@holbrookfire.com before 5:00 p.m. on Friday, February 15, 2019 so as to allow adequate time for a response and for all interested bidders to make corrections, modifications, or withdrawals to their bids. Written responses will be emailed to all solicited vendors and/or bidders having submitted bids/quotes.

A bidder may correct, modify, or withdraw a bid by written notice received by the Town prior to the time and date set for the bid opening. Bid modifications must be in writing, and must contain in the Subject Line:

"Modification No.__." Each modification must be numbered in sequence, and must reference the original

Invitation for Bids. Corrections, modifications, and withdrawals will be accepted at the Holbrook Fire

Department until 12:00 p.m. on Friday, February 22, 2019.

Other Information

• Pre-Bid Conference: Not Applicable/None.

• Town’s Right to Cancel or Reject Bids: The Town may cancel this Invitation for Bids, or reject in whole or in part any and all bids, if the Town determines that cancellation or rejection serves the best interests of the

Town.

• Bid Pricing Requirements: All bid prices submitted in response to this Invitation for Bids must remain firm for forty-five (45) days following the posted Bid Opening Date and Time.

• Unexpected Situations: If, at the posted Bid Opening Date and Time, bids are unable to be opened due to uncontrolled events such as fire, snow, ice, wind, building evacuation, information/technology malfunctions mailto:chiefmcfadden@holbrookfire.com

Invitation for Bids Notice or similar unpredictable events, the bid opening will be postponed until 2:00 p.m. on the next normal business day. Bids will be accepted until the amended date and time.

• Trade-in Requirements: Contractors that agree to accept trade-ins must negotiate in good faith with the

Holbrook Fire Department with regard to trade in value at the time of trade-in. The vendor awarded this contract must accept Fire Equipment trade-ins that are an equal of the product being purchased.

• Worker’s Compensation Certificate: The vendor awarded this contract shall provide proof of Worker's

Compensation at statutorily required limits. Within five days of notice of award, the successful bidder shall supply the Town with an insurance certificate showing coverage in place for any work that may be performed on Town of Holbrook property, and naming the Town of Holbrook as an additional insured.

• General Liability Insurance Certificate: The vendor awarded this contract shall provide evidence of general liability insurance in the amount of $500,000.00 for all risks. Within five days of notice of award, the successful bidder shall supply the Town with an insurance certificate showing coverage in the place for any work to be performed on Town of Holbrook property, and naming the Town of Holbrook as an additional insured.

• State and Federal Regulation Compliance: The vendor awarded this contract shall comply with all applicable federal and state regulations, including but not limited to, Immigration and Naturalization

Service, OSHA, MCAD, Right-to-Know.

• Business Relationship: The vendor awarded this contract shall act as an independent contractor, and shall provide all labor, fringe benefits, and related overhead.

Bid Submission Requirements

• Number of Copies Required to be Submitted: Two (2) Original Signed and Executed Bid Submissions.

• Required Markings on Bid Envelopes: The bid package shall be clearly marked on the outer portion of the envelope as a “Power-Lift/Power-Load Stretcher System Purchase and Installation Bid”.

• Non-Collusion Form: Required. Include with Bid.

• Tax Compliance Certificate: Required. Include with Bid.

• Bid Pricing Sheet: Required (on bidder’s company letterhead). Include with Bid.

• Bid Specifications Checklist: Required. Include with Bid.

• Reference Form: Required. (use bidder’s company letterhead). Include with Bid.

• Bid Authorization: A bid must be signed as follows: 1) if the bidder is an individual, by her/him personally;

2) if the bidder is a partnership, by the name of the partnership, followed by the signature of each general partner; and 3) if the bidder is a corporation, by the authorized officer, whose signature must be attested to by the Clerk/Secretary of the corporation and the corporate seal affixed.

• Bonding Requirements (performance or payment bonds): Not Required.

• Bid Deposit: Not Required.

Holbrook Board of Selectmen

Holbrook Fire Chief

Scope of Work and Specifications

Section I

SCOPE OF WORK

1. SCOPE OF WORK:

The Town of Holbrook Fire Department (herein referred to as “Town” or “Department”) is requesting proposals from qualified vendors for the purchase and installation of two (2) Power-Load Stretcher Systems and two (2) Power-Lift

Stretchers with extended seven (7) year warranties into two (2) Class I Ambulances operated by the Holbrook Fire

Department. Installation of said equipment must be in full compliance with the Specifications contained in Section II.

2. PRICES AND PRICE ADJUSTMENTS:

All pricing shall include any and all charges that may be imposed in fulfilling the terms of the resulting contract including purchase, shipping/delivery, warranty, and installation.

3. DELIVERY OF EQUIPMENT AND INSTALLATION:

The Department requires delivery to be made within the shortest time possible after the date of award. To allow for installation of equipment, the Holbrook Fire Department agrees to deliver each of the Town’s two (2) Class I Ambulances

(at a staggered interval so as not to impede the Town’s emergency operations), to a certified installation location that must be within a 50-mile radius of Holbrook Fire Headquarters, at a time and for a duration that is mutually agreeable to the

Town and the awarded Vendor. All equipment must be delivered, installed, and accepted by the Town as soon as is practicable, but in no event later than June 30, 2019. Bidders are required to provide an estimated time frame for the arrival of the equipment at a certified installation location, and an estimate for time needed to complete installation(s).

4. QUALITY OF EQUIPMENT:

The quality of the required equipment and installation of same is critical due to the emergency nature of the intended use.

Bidders may find limited use of brand names in the specifications, however it is expressly noted that such use of brand names has only been included in an effort to acquaint bidders with the general type of item(s) required and as a reference by which alternate or competitive items offered may be judged. Any competitive items that are of an equal or superior quality and of the same reputation for quality and workmanship as any brand names included in the specifications will be considered. Any variations between the items described in the specifications and those being offered must be fully explained by the bidder as part of the bid. In the absence of any changes by the bidder, it will be presumed and required that the items described in these specifications will be delivered and installed by a certified vendor and installation shop.

The Town of Holbrook/Holbrook Fire Department shall be the sole judge concerning whether or not a proposal meets these specifications and requirements.

5. EVALUATION OF BIDS:

The Town reserves the right to evaluate all bids submitted and determine whether or not the proposed system and equipment will meet the department’s operational needs and standards.

Section II

SPECIFICATIONS

It is the intent of the Town to purchase from a qualified vendor two (2) Power Load Stretcher Systems and two (2) Power

Lift Stretchers with extended seven (7) year warranties capable of supplying and installing said equipment into (2)

Holbrook Fire Department Class I Ambulances.

POWER LIFT STRETCHERS:

A. Stretcher Specifications:

Powered ambulance stretchers/cots. Quantity: Two (2). Per specifications and/or superior/equivalent to Stryker Model

Power-Pro XT (XPS) Stretchers.

Independent Qualification

• The stretcher/system shall have the following independent certifications (International Protection Marking &

International Electromechanical Commission):

IPX6: The system shall be rated to withstand powerful water jets.

IEC 60601-1 and IEC 60601-1-2: This certification indicates that medical electrical equipment conforms to industry standards for mechanical and electrical safety for medical electrical devices, as well as electromagnetic compatibility and immunity.

Crash Standards

• The stretcher/system must meet the following dynamic crash test standards (Society of Automotive Engineers, European Committee for Standardization & Standards Australia and Standards New Zealand):

SAE J 3027:2016 Ambulance Litter Integrity, Retention, and Patient Restraint

EN 1789:2007 Medical vehicles and their equipment – Road ambulances

AS/NZS 4535:1999 Ambulance restraint systems

Use Specifications

• The stretcher shall have a weight capacity of 700 pounds.

• The battery shall be placed at the foot end of the stretcher and be easily accessible in any situation.

• The stretcher legs shall power-retract in under 2.5 seconds.

• The stretcher provides a load height of at least thirty-six (36”) inches and the preset stopping position is operator-adjustable to match the deck height of the transport vehicle.

• The foot end of the stretcher provides dual-height lifting bars and separate operator controls (one control per position) providing optimum ergonomics to numerous operator heights.

• The foot end of the stretcher should contain a large battery indicator light which displays amber or green depending on battery level. A warning should be given by a flashing amber light, allowing the operator time to change the battery.

• The wheels on the stretcher must be 6” x 2” sealed bearing casters.

• An integrated bumper system shall be a standard feature on the cot.

• The stretcher shall have a retractable head section (not a hinged head section). This feature allows the cot to be lowered to the ground in the shortened position.

• When unloading with the manual release handle, the stretcher shall utilize a hydraulic dampening system to ensure cot will not abruptly jar the operator or the patient.

• The stretchers frame weight (with battery) must be 127 pounds or less.

• The Power Lift Stretcher(s) shall be fully compatible with the Power-Load System(s) and shall perform as a unit.

Maintenance

• The stretcher should feature a foot-end-mounted hourly usage meter to assist in determining the timing of preventative maintenance checks.

• The stretcher must be powder-coated on the entire aluminum frame (including the patient handling surfaces), thus eliminating aluminum oxidation throughout the cot.

• All caster bearings shall be of the sealed type eliminating costly lubrication.

• The stretcher shall be power washable and shall meet IPX6 pressure jet certification (see above).

Required Features

The Power Stretcher shall include the following list of standard and optional features:

• Dual wheel lock

• Patient right cot retaining post

• Standard components

• Extended Patient Surface side rail option

• Equipment hook

• Power-Load compatibility

• Knee-catch / Trendelenburg

• Retractable head section oxygen

• Pocketed backrest pouch

• Head end storage flat

• English manual

• 120V charging kit

• J-hook

• Extended Patient Surface knee catch bolster mattress

• Steer lock option

• 3-stage IV pole – patient right

• SAE J 3017:2016 compliant patient restraint package

• Standard fowler

Warranty

The Power Stretcher/Cot system shall include the following warranty:

• 7-year extended protection to include parts, labor, travel and annual preventive maintenance.

POWER LOAD SYSTEMS:

Powered ambulance stretcher/cot loading and fastener system to be mounted within the patient compartment of two (2)

Holbrook Fire Department ambulances. Quantity: Two (2). Per specifications and/or superior/equivalent to Stryker

Power-LOAD (Model 6390) stretcher fastening system.

B. Power Load System Specifications:

Independent Certifications

• The system shall have the following independent certifications (International Protection Marking & International

Electromechanical Commission:

IPX6

IEC 60601-1 and IEC 60601-1-2

KKK-A-1822

• The system shall meet the following dynamic crash test standards (Society of Automotive Engineers, European

Committee for Standardization & Standards Australia and Standards New Zealand):

SAE J 3027:2016 Ambulance Litter Integrity, Retention, and Patient Restraint

EN 1789:2007 Medical vehicles and their equipment – Road ambulances.

AS/NZS 4535:1999 Ambulance restraint systems.

• The Power-Load system shall be capable of lifting patients weighing up to 700 lbs.

• The system shall support the patient and cot throughout the loading and unloading process.

• The system shall provide a linear guide for cot through the loading and unloading process.

• The system shall be equipped with LED indicators which communicate system status to the operator.

• The system shall have wireless communication capabilities.

• The system shall provide a method of inductive charging for associated batteries without the use of cables or connectors.

• The system shall provide a method of operation for powered ambulance cots and non-powered ambulance cots.

• The system shall have the ability to continue to operate in the event the system loses power or experiences an error.

• The Power-Load System(s) shall be fully compatible with the Power Lift Stretcher(s) and shall perform as a unit.

Options/Features

• The Power-Load system shall include the following options/features:

Floorplate option.

Operation manual

Warranty

The Power-Load system shall include the following warranty:

• 7-year extended protection to include parts, labor, travel, and annual preventive maintenance.

INSTALLATION:

C. Installation Specifications:

The Holbrook Fire Department currently operates two Class I ambulances:

1. Ambulance 1 – 2008 Ford F450 Superduty Road Rescue “Ultramedic” Type 3, Class I Emergency Medical

Vehicle (Ambulance)

2. Ambulance 2 – 2013 Ford F550 4x4 Superduty custom built Life Line “Superliner” Type I, Class I Emergency

Medical Vehicle (Ambulance)

The Holbrook Fire Department will be accepting delivery of a 2019 Ford F550 4x4 Superduty custom built Life Line

“Superliner” Type I, Class I Emergency Medical Vehicle on or about June 15, 2019, which will replace the vehicle listed in Item 1 above. The Holbrook Fire Department intends to install the two (2) Power Load Stretcher Systems and two (2)

Power Lift Stretchers into the 2013 Ford F550 4x4 Superduty custom built Life Line “Superliner” Type I, Class I

Emergency Medical Vehicle (Ambulance) and the new 2019 Ford F550 4x4 Superduty custom built Life Line

“Superliner” Type I, Class I Emergency Medical Vehicle (Ambulance).

Due to the extensive original warranties provided by Life Line Emergency Vehicles (“Life Line”) in the initial build out of these ambulances and mandatory requirements for the installation of the equipment being bid, the bidder shall include written documentation from Life Line Emergency Vehicles stating that the bidder is authorized to perform work on the

Life Line product line and that any installation of said equipment will not void existing or future warranties. All installation work shall be performed by an authorized Life Line service center.

There will be no exceptions to this requirement!

At minimum the bidder shall identify the installation service center company and location, (including street address, phone number, municipality, and contact name on company letterhead) as a component of the proposal. The installation center shall be within a 50-mile radius from the Headquarters of the Holbrook Fire Department so as to reasonably enable the Holbrook Fire Department to deliver and retrieve the Ambulances prior to and upon completion of the installation process. The bidder shall identify the quantity and location of all similar Power-Lift/Power-Load Stretcher System installations in ambulances performed over the past 12 months.

The bidder shall supply additional accessories/materials and perform the following specific activities related to installation of equipment:

• Remove any existing stretcher retention systems, including but not limited to rear push bars and front “antler-type” stretcher retention components.

• Install floor plates as provided with Power-Load systems and in compliance with manufacturer’s recommendations. Any stretcher retention mounting equipment that must be recessed into the floor for proper installation (e.g. - Floor Mounting Blocks, Floor Plates, etc.) must require a routing or recess depth/cavity of no more than one-half inch (½”). Floor Mounting Blocks, Floor Plates, etc. must be installed in a manner that provides direct contact with the surface of the floor (i.e. – the addition of shims/filler material will not be an allowed installation technique to enable Floor Mounting Blocks, Floor Plates, etc. to achieve the maximum routing or recess depth/cavity of one-half inch (½”) in order to meet this requirement).

• Seal between floor and floor plate to prevent dirt and fluids from entering under the plate.

• Reinforce the underside of the module body with minimum 5” wide x .250” thick T-6061 aluminum in accordance with Life Line AutoCAD drawings.

• Wiring into Life Line electrical system in accordance with Life Line requirements.

Scope of Work and Specification Checklist

POWER LOAD SYSTEMS:

Power Load System Specification Checklist:

Independent Certifications

• The system complies with the following independent certifications:

o IPX6 o IEC 60601-1 o IEC 60601-1-2 o KKK-A-1822

• The system meets the following dynamic crash test standards:

o SAE J 3027:2016 o EN 1789:2007 Medical vehicles and their equipment – Road ambulances o AS/NZS 4535:1999 Ambulance restraint systems

Use Specifications

• The Power-Load system is capable of lifting patients weighing up to 700 pounds

• The system supports the patient and cot throughout the loading and unloading process

• The system provides a linear guide for cot through the loading and unloading process

• The system is equipped with LED indicators which communicate system status to the operator

• The system has wireless communication capabilities

• The system provides a method of inductive charging for associated batteries without the use of cables or connectors

• The system provides a method of operation for powered ambulance cots and non-powered ambulance cots

☐-Meets Spec. ☐-Does Not Meet Spec. ☐-Exception

• The system has the ability to continue to operate in the event the system loses power or experiences an error

• The Power-Load System(s) are fully compatible with the Power Lift Stretcher(s) and perform as a unit

Options/Features

• The Power-Load system includes the following options/features:

o Floorplate Option o Operation manual

Warranty

The Power-Load system includes the following warranty:

• 7-year extended protection to include parts, labor, travel, and annual preventive maintenance

POWER LIFT STRETCHERS:

Power-Lift Stretcher Specification Checklist:

Independent Qualification

• The stretcher complies with all of the following independent certifications:

o IPX6:

o IEC 60601-1 o IEC 60601-1-2

Crash Standards

• The stretcher meets the following dynamic crash test standards:

o SAE J 3027:2016 o EN 1789:2007 Medical vehicles and their equipment – Road ambulances o AS/NZS 4535:1999 Ambulance restraint systems

• The stretcher has a weight capacity of 700lbs

• The battery is placed at the foot end of the stretcher and is easily accessible in any situation

• The stretcher legs are capable of power-retraction in under 2.5 seconds

• The stretcher is capable of providing a load height of at least thirty-six (36”) inches and the preset stopping position is operator-adjustable to match the deck height of the transport vehicle

• The foot end of the stretcher provides dual-height lifting bars and separate operator controls (one control per position) providing optimum ergonomics to numerous operator heights

• The foot end of the stretcher contains a large battery indicator light which displays amber or green depending on battery level

• A warning signal consisting of a flashing amber light indicates a critically low battery

• The wheels on the stretcher are 6” x 2” sealed bearing casters

• An integrated bumper system is present on the stretcher

• The stretcher has a retractable head section which allows the cot to be lowered to the ground in a shortened position

• When unloading with the manual release handle, the stretcher utilizes a hydraulic dampening system to ensure that cot does not abruptly jar the operator or the patient

• The stretcher frame weighs 127 pounds (or less)

• The Power Lift Stretcher(s) is fully compatible with the Power-Load System(s) and performs as a unit

Maintenance

• The stretcher features a foot-end-mounted hourly usage meter to assist in determining the timing of preventative maintenance checks

• The stretcher is powder-coated on the entire aluminum frame (including the patient handling surfaces)

• All caster bearings are of the sealed type variety

• The stretcher is power-washable and meets IPX6 pressure jet certification

Other Features

The Power Stretcher shall include the following list of standard and optional features:

• Power Stretcher features dual wheel locks

• Power Stretcher features a “patient right” cot retaining post

• Power Stretcher features Extended Patient Surface side rail option

• Power Stretcher features an equipment hook

• Power Stretcher features a knee-catch

/Trendelenburg position capability

• Power Stretcher features a retractable head section oxygen storage system

• Power Stretcher features a pocketed backrest pouch

• Power Stretcher features a flat head end storage system

• Power Stretcher features a user manual (English)

• Power Stretcher features a 120V smart charging kit

• Power Stretcher features a safety J-hook

• Power Stretcher features an Extended Patient

Surface knee-catch type bolster mattress

• Power Stretcher features a steering lock

• Power Stretcher features a 3-stage IV pole (patient right)

• Power Stretcher features a SAE J 3017:2016 compliant patient restraint package

• Power Stretcher features a standard fowler capability

Warranty

The Power Stretcher/ Cot system includes the following warranty:

• 7-year extended protection to include parts, labor, travel and annual preventive maintenance.

INSTALLATION:

Installation Specification Checklist:

Installation Requirement

• Any stretcher retention mounting equipment that must be recessed into the patient compartment floor for proper installation (e.g. - Floor Mounting Blocks, Floor Plates, etc.) must require a routing or recess depth/cavity of no more than one-half inch (½”) without use of shims/filler materials to allow for a flush finish with the patient compartment floor.

Installation Service Center

• Location is within 50-miles of Holbrook Fire

Department Headquarters

• Installation Service Center is authorized to perform work on Life Line products

• Installation Service Center guarantees that installation will not void existing or future vehicle warranties (include documentation with bid)

• Installation Service Center guarantees that installation will not void existing or future power-load system warranties

• Installation Service Center guarantees that installation will not void existing or future power-lift stretcher warranties

• The Installation Service Center is capable of suppling the following additional accessories/materials and performing the following specific activities related to installation of equipment:

o Removing any existing stretcher retention systems, including but not limited to rear push bars and front antler systems o Installing floor plates as provided with

Power-Load systems and in compliance with manufacturer’s recommendations o Sealing between the ambulance floor and floor plate so as to prevent dirt and fluids from entering under the plate o Reinforcing the underside of the ambulance module body with a minimum of five-inch wide (5”) x one-quarter inch thick (0.250”)

T-6061 aluminum (in accordance with Life

Line AutoCAD drawings) o Wiring the Power-Load System into the Life

Line ambulance electrical system in accordance with Life Line requirements and

KKK-specifications

Exceptions to the Scope of Work and Specifications

☐ This bid, submitted by ____________________________, contains no exceptions to the Scope of Work and/or Specifications

☐ This bid, submitted by ____________________________, contains the following exceptions to the Scope of Work and/or

Specifications:

(Attach additional sheets if necessary)

BID AUTHORIZATION

The undersigned certifies under penalties of perjury that submission of this bid has been authorized:

1) If the bidder is an individual, by her/him personally; or,

2) If the bidder is a partnership, by the name of the partnership, followed by the signature of each general partner; or,

3) If the bidder is a corporation, by the authorized officer, whose signature must be attested to by the

Clerk/Secretary of the corporation and the corporate seal affixed.

Attested:

Signature

Printed Name

Title

Printed Name

Printed Name

(Affix Corporate Seal if Applicable)

CERTIFICATE OF NON-COLLUSION

The undersigned certifies under penalties of perjury that this bid or proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the work "person" shall mean any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group or individuals.

(Signature of person signing bid)

(Date)

(Printed name of person signing bid)

(Name of business)

CERTIFICATE OF TAX COMPLIANCE

The undersigned certifies under penalties of perjury that I, to my best knowledge and belief, have filed all state tax returns and paid all state taxes as required under law.

*Signature of Individual By: Corporate Officer

** Social Security # (Voluntary) or Federal Identification Number

Your social security number or tax identification number will be furnished to the Massachusetts

Department of Revenue to determine whether you have met tax filing or tax payment obligations.

Failure to comply will subject the vendor to termination of this contract.